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House of Lords – Allergy Report 2007 – Evidence

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House of Lords – Allergy Report 2007 – Evidence HOUSE OF LORDS Science and Technology Committee 6th Report of Session 2006–07 Allergy Volume II: Evidence Ordered to be printed 24 July 2007 and published 26 September 2007 Published by the Authority of the House of Lords London : The Stationery Office Limited £28.50 HL Paper 166-II CONTENTS Page Oral Evidence Department of Health Written evidence from Department of Health, Health and Safety Executive, Department for Work and Pensions, Department for Education and Skills, Department for Communities and Local Government 1 Oral evidence (22 November 2006) 16 Supplementary written evidence from Department of Health 25 Health and Safety Executive, Department for Education and Skills, Department for Work and Pensions, Department for Communities and Local Government Oral evidence (22 November 2006) 26 Supplementary written evidence from Department for Work and Pensions 35 Professor Peter Burney, Professor Aziz Sheikh, Dr Graham Devereux, Professor John Warner Written evidence from Professor Peter Burney 37 Oral evidence (6 December 2006) 41 Supplementary written evidence from Professor Peter Burney 60 Professor Stephen Durham, Professor Peter Barnes, Professor Andrew Wardlaw, Professor Anthony Frew Written evidence from the British Society for Allergy and Clinical Immunology 62 Written evidence from the European Academy of Allergology and Clinical Immunology 66 Oral evidence (18 December 2006) 71 Professor Tak Lee, Dr Diana Dunstan, Mr Dave Allen, Professor John Westwick Oral evidence (18 December 2006) 82 Supplementary written evidence from the Medical Research Council 91 Professor Anthony Newman Taylor, Mr Rob Miguel, Professor Raymond Agius, Dr David Orton Written evidence from Professor Anthony Newman Taylor 92 Written evidence from Professor Raymond Agius 93 Oral evidence (10 January 2007) 94 Supplementary written evidence from Professor Raymond Agius 111 Dr Mark Levy, Dr Susan Leech, Dr William Egner, Dr Pamela Ewan Written evidence from the Royal College of General Practitioners 112 Written evidence from the Royal College of Paediatrics and Child Health 115 Written evidence from the Royal College of Pathologists 120 Written evidence from the National Allergy Strategy Group 126 Oral evidence (17 January 2007) 131 Mrs Sue Hattersley, Miss Gill Fine, Ms Andrea Martinez-Inchausti, Dr Ian Leitch, Mr Les Bailey Written evidence from the Food Standards Agency 148 Oral evidence (31 January 2007) 159 Supplementary written evidence from the Food Standards Agency 169 Further Supplementary written evidence from the Food Standards Agency 170 Ms Mandy East, Professor Gideon Lack, Dr Richard Pumphrey, Mrs Hazel Gowland Written evidence from the Anaphylaxis Campaign 170 Supplementary written evidence from the Anaphylaxis Campaign 179 Written evidence from Dr Richard Pumphrey 180 Oral evidence (31 January 2007) 180 Supplementary written evidence from Dr Richard Pumphrey 188 Mr John Bryson, Professor Adnan Custovic, Dr Paul Harrison, Mr Grant Ager Written evidence from the Chartered Institute of Environmental Health 190 Oral evidence (7 February 2007) 191 Professor Jonathan Brostoff, Ms Kate Chatfield, Professor Chris Corrigan, Professor Edzard Ernst Written evidence from the Society of Homeopaths 202 Written evidence from Professor Chris Corrigan 204 Oral evidence (21 February 2007) 208 Supplementary written evidence from the Society of Homeopaths 217 Dr Jean Monro, Dr Damien Downing, Mr Don Harrison, Professor Simon Wessely Written evidence from Dr Jean Monro 219 Written evidence from the British Society for Ecological Medicine 220 Written evidence from the British Institute for Allergy and Environmental Therapy 224 Written evidence from Professor Simon Wessely 227 Oral evidence (21 February 2007) 227 Supplementary written evidence from the British Society for Ecological Medicine 235 Supplementary written evidence from the British Institute for Allergy and Environmental Therapy 235 Mrs Margaret Cox, Professor David Gawkrodger, Dr Clive Grattan, Dr Shuaib Nasser Written evidence from the British Association of Dermatologists 237 Oral evidence (28 February 2007) 238 Professor John Harper, Professor Jonathan Hourihane, Dr Warren Hyer, Dr Mark Rosenthal Written evidence from Professor Jonathan Hourihane 252 Written evidence from Dr Mark Rosenthal 252 Oral evidence (7 March 2007) 253 Ms Joy Winks, Ms Sarah Day Oral evidence (7 March 2007) 265 Supplementary written evidence from the Royal College of Nursing 270 Dr Gill Hart, Mr Richard Gutowski, Ms Helen Young, Mr Andrew Dillon Written evidence from Yorktest Laboratories Ltd 272 Oral evidence (15 March 2007) 273 Supplementary written evidence from Yorktest Laboratories Ltd 281 Supplementary written evidence from the Medicines and Healthcare products Regulatory Agency 283 Dr Glenis Scadding, Dr Clare Mills, Ms Donna Covey, Ms Lindsey McManus Written evidence from the Royal National Throat Nose and Ear Hospital 284 Written evidence from the Institute of Food Research 285 Written evidence from Asthma UK 288 Written evidence from Allergy UK 291 Oral evidence (15 March 2007) 294 Supplementary written evidence from Allergy UK 303 Mr Ivan Lewis MP, Department of Health Oral evidence (18 April 2007) 304 Supplementary written evidence from the Department of Health 320 Written Evidence Advertising Standards Authority 325 British Occupational Health Research Foundation 338 British Thoracic Society 341 Dr A T Clark and Dr P W Ewan 342 Coeliac UK 342 Faculty of Homeopathy 346 Royal College of Anaesthetists 350 Latex Allergy Support Group 351 The Patent Office 354 Research Councils UK 367 Royal College of Physicians 373 Royal Pharmaceutical Society of Great Britain 374 Royal College of Midwives 384 Wellcome Trust 385 The Committee’s Report drawing on this oral and written evidence is published as a separate volume, HL Paper 166-I. Minutes of Evidence TAKEN BEFORE THE SELECT COMMITTEE ON SCIENCE AND TECHNOLOGY (SUB-COMMITTEE I) WEDNESDAY 22 NOVEMBER 2006 Present Broers, L Platt of Writtle, B Colwyn, L Simon, V Finlay of Llandaff, B Soulsby of Swaffham Prior, L (Chairman) Taverne, L May of Oxford, L Memorandum by the Department of Health Introduction 1. The Government welcomes this opportunity to set out its position on allergy and allergic conditions. 2. This memorandum is structured in accordance with the particular questions asked in the Committee’s Call for Evidence. Although this inquiry will not focus primarily on allergy service provision, many of its questions were addressed in the recently completed review of services for allergy (“the DH review”) that was undertaken by the Department of Health (DH) following an inquiry (Report, November 2004) by the House of Commons Health Committee. 3. This memorandum therefore refers to—but does not repeat at length—the evidence presented in the report of the DH review, A review of services for allergy—the epidemiology, demand for and provision of treatment and eVectiveness of clinical interventions, published in July 2006. Members of the Committee have had printed copies of this report. It is available on the DH website, along with supporting information on the epidemiology and on clinical interventions, at: http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/ PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT–ID%4137365&chk%/Z3Wtj. 4. The memorandum includes contributions from: — the Health and Safety Executive (HSE) and the Department for Work and Pensions (DWP), covering work-related allergy and Industrial Injuries Disablement Benefit, attached as Annex A; — the Department for Education and Skills (DfES) on allergic diseases and schools—including a summary of medicines guidance to schools, attached as Annex B; and — the Department for Communities and Local Government (DCLG) on housing policy and regulations, attached as Annex C. 5. The key points made in Annex A are that: — work-related allergies have declined over the last 10 years; — HSE is working in partnership with key stakeholders to ensure this downward trend continues; and — there is a robust regulatory framework in place to tackle work-related allergies. Defining the Problem What is allergy? 6. Allergy can be defined as a hypersensitivity, a heightened or exaggerated immune response to some external stimulus or stimuli. Allergic processes contribute to a range of conditions—including asthma, rhinitis and eczema—many of which also occur in the absence of a specific allergy. Various allergic conditions often co-exist in the same individual. Also, some individual allergic disorders may cause symptoms in several organ systems simultaneously. 2 allergy: evidence 22 November 2006 7. Allergy is very common. Around a third of the population have some form of allergy at some point in their lives. In England, about three million people each year are seen in primary care with conditions that may be allergic in origin. What is the difference between allergy and intolerance? 8. Unlike allergy, intolerance (for example, food intolerance) does not involve the immune system. It is generally not life threatening. Around 20 per cent of adults have perceived food intolerance. The correct diagnosis of food intolerance generates a substantial workload for services. What is and what is not known about the origins and progression of allergic disease? 9. Whilst a good deal is known about the mechanisms of allergic processes, the underlying causes of allergic conditions in individuals and populations are more diYcult to understand. A variety of factors have been identified as possible
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